American Ambulance Association

LEADING THE WAY TO SUCCESS ON CAPITOL HILL American Ambulance Association 8400 Westpark Drive, 2 nd Floor McLean, VA 22102 1-800-523-4447 www.the-aaa.org

Dear Ambulance Service Professional: As part of our ongoing effort to serve the needs of our members, the American Ambulance Association (AAA) has revised this handbook for grassroots legislative advocacy. Filled with practical tips on how to become a successful advocate, we have designed this information to help ambulance service professionals make the greatest impact on federal legislation that affects the services we provide America s communities. The opportunity to involve oneself in legislative decision-making is a privilege enjoyed in only a few nations of the world. By becoming an active grassroots participant, you will help pass laws that ensure our industry s prominent role in the redesign of the nation s emergency medical services (EMS) and public health care system. You will also be assisting in the effort to assure that government regulations support the evolution of a vibrant and sustainable ambulance industry. In order for favorable federal legislation to pass, each of us must generate support in our local community. We hope you will use this information to communicate with lawmakers, engage others in your efforts, and create more awareness in our communities about the challenges facing our industry. Our collective effort to provide solutions to these challenges will have a profound impact on the continued health and prosperity of millions of Americans. Thank you for getting involved in the AAA s effort to improve the services the ambulance industry provides America s communities. We appreciate your commitment to leading the way to success on Capitol Hill. We also hope that you make political action part of your organization s business plan and part of the job description of key managers of your service. Mike Hall, President American Ambulance Association 1 7/1/2015

TABLE OF CONTENTS INTRODUCTION Why Advocacy is Important... 3 CHAPTER 1 How a Bill Becomes Law... 6 CHAPTER 2 Legislative Advocacy: Understanding What Moves Politicians and How to Be a More Persuasive Advocate... 8 CHAPTER 3 Community Outreach: How to Urge Others to Champion Your Issue... 18 CHAPTER 4 Media Relations: Why You Should Be Courting the Press... 22 CHAPTER 5 How to Host a Congressional Ambulance Ride Along: Complete Ambulance Ride-Along Tool Kit... 29 CHAPTER 6 Political Primer: How to Host a Fundraiser... 44 CHAPTER 7 Resources for Effective Advocacy... 49 CHAPTER 8 Glossary... 51 2 7/1/2015

INTRODUCTION: Why Advocacy is Important Congress shall make no law respecting the establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press, or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances. - First Amendment of the Constitution of the United States Our nation sprung from the courageous efforts of advocates. Sparked by an unwillingness to live without certain freedoms and blessed with community leaders willing to break the bonds of convention, our founding fathers waged a massive advocacy campaign that assembled citizens behind a common cause. Their advocacy efforts resulted in an entirely new system of government and a radical new way of living based on the philosophies of freedom and choice. The AAA s : Leading the Way to Success on Capitol Hill is designed to teach and inspire you to also be an effective advocate. Filled with practical tips on how to become a successful advocate, the AAA has designed this information to help ambulance services make the greatest impact on the federal legislative process and, ultimately, assure that federal laws allow the industry to continue to provide the best ambulance services in America s communities. Forces Influencing Members of Congress The three groups of individuals with the potential to influence the actions of members of Congress related to ambulance issues are: Ambulance Advocates Ambulance executives, managers, employees and organizations familiar with ambulance issues and who are able to take immediate action to influence lawmakers. Ambulance advocates make direct contact with the member of Congress through personal meetings, phone calls, letters, emails, and faxes. Third-Party Advocates Individuals, organizations and the public-at-large who are constituents of the member of Congress and are urged to take action to influence lawmakers. Third party advocates support issues affecting their community by contacting a member of Congress through phone calls, emails letters, and faxes. Local Media Newspapers, television news, radio news and business journals that report current news events and information about issues that affect the local community. The local media highlights community issues through news articles, 3 7/1/2015

news broadcasts and editorials, with potential to generate public support for solutions. Ambulance Advocates Member of Congress Third-party Advocates Local Media This grassroots roadmap will teach you how to implement key strategies to help you win your issue on Capitol Hill. You will be provided with step-by-step instructions to plan activities to support your issues, develop a relationship with your members of Congress and to provide information to the entities that influence members of Congress. Those who do not engage in the political process send the message that they approve of the status quo. When every ambulance provider in America reaches out to their elected Congressional representative (House and Senate) and educates him or her about ambulance issues, our collective efforts on Capitol Hill will achieve the following results that benefit ambulance providers nationwide: Creates or maintains a favorable business environment Enhances a lawmaker s opinion of our industry Minimizes unfavorable legislation Establishes contacts within government before a crisis arises Effective legislative advocacy, or lobbying, will produce these benefits for your local operation as well: Local field and management personnel are more politically aware and involved in community activities Local and state officials understand the issues that are beyond local control and support federal advocacy efforts 4 7/1/2015

Relationships with local community leaders build opportunities to ask for support as third party advocates The local public is better informed about quality and efficient ambulance services Local media is educated about the issues affecting ambulance services in the community We know that time is precious. However, we project that you will invest just 3 to 6 hours per year to become politically active with your members of Congress. This includes contacting by letter or telephone your member of Congress approximately six times per year on issues; and making personal contacts approximately once per month at a community event or activity. While lobbying a member of Congress can appear to be overwhelming, taking the time to place a call or schedule a meeting will pay off for your operation. Inaction will not. The most difficult and critical task is devoting time to the issue. For questions about this guide, contact the AAA headquarters at 1-800-523-4447. To learn more about the AAA and its advocacy efforts go to www.the-aaa.org. 5 7/1/2015

Bill Drafting and Introduction CHAPTER 1 How a Bill Becomes Law Only members of Congress may propose or sponsor a new law. Ideas for laws can come from citizens, interest groups, or public officials such as a Governor. The ideas for new laws are then drafted as bills and filed with the clerk of the House and/or the Senate who assigns the bill number. The bill is formally introduced when the clerk of the chamber of origin reads aloud the bill s number, sponsor and title on the floor during a legislative session. Bill sponsors will seek support for their legislation from other members of Congress by asking them to become a co-sponsor of their legislation. In keeping with a bicameral or two chamber legislature, frequently a companion bill will be introduced in the opposite chamber. Debate in Committee The bill is then sent to the committee that has policy-making authority to make any changes or additions in the form of amendments. This is called the mark-up process. After debate, members will vote on the bill to pass it out of their committee. If the majority votes against the bill, it is reported unfavorably out of committee and is considered dead. If the majority votes in favor of the bill, it will be reported favorably and sent back to the floor for consideration by the entire chamber. Full Chamber Debate Once the committee of jurisdiction approves the bill, it will be formally read to the full chamber and opened for debate and voting. Because of strict governing rules, it is very difficult to amend a bill on the House floor. By limiting debate, the House floor process is more efficient than that of the Senate. The House spends several hours to consider a typical bill and up to three days for a major bill. Any Senator may offer an amendment on the Senate floor, often resulting in a much slower and deliberate legislative process than that of the House. It is common for a major bill in the Senate to contain more than one hundred amendments. The Senate will debate a typical bill for one or two days and as long as a week or more for a major bill. When bills are debated on the floor, they are subject to a multitude of tactics employed by members of both houses to delay or prevent a vote on a bill. The most common of these is called a filibuster and is most frequently used in the Senate where parliamentary rules are less stringent than in the House. Members who are in the minority or people who oppose the passage of the bill can use time-delaying tactics in an attempt to symbolize their opposition or draw out more debate. The stricter rules used by the House make filibusters more difficult, but delaying tactics are employed occasionally through various procedural devices allowed by House rules. 6 7/1/2015

Conference Committee Once the bill has passed both the House and the Senate, it is then ready to be conferenced with its counterpart in the other chamber. A conference committee consisting of members of Congress from both chambers will be assigned to work out any differences between the House and Senate versions resulting in agreement on the final version. This final bill will be voted on by both chambers, and if passed, will then be sent to the President for his signature. Presidential Signature or Veto Once the President signs a bill, it is considered a law. The law takes affect on the date of enactment. The President may veto a bill by refusing to sign it and returning it to the Legislature. In some cases, Congress can override the veto with a two-thirds roll call vote in both chambers making the measure law without the President s signature. Fewer than ten percent of all bills introduced actually become law. Implementing the Law: The Regulatory Process Enacting legislation is only part of the process. After a legislative body enacts legislation, departments and agencies of the Executive Branch are responsible for implementation. The new law provides the outline of a program or policy. It is the responsibility of the Executive Branch, through the regulatory process, to create specific policies and procedures established by the new law. The regulations may specify a program s operating procedures, determine how funds may and may not be spent or determine qualifications for participation in a program. The process begins with the publication of the proposed regulation. It is during this official public period that interested parties can comment and influence the proposed regulations. 7 7/1/2015

CHAPTER 2 Legislative Advocacy: Understanding What Moves Politicians and How to be a More Persuasive Advocate What Moves Politicians? Members of Congress follow hundreds of bills presented each session and do not have enough time to study each bill. For this reason, many lawmakers rely on personal visits from lobbyists and constituents to give them information on issues. While a variety of factors influence the decisions of members of Congress, two principal concerns guide them: Desire to make good public policy; and Desire to make decisions to help their constituents who in turn will vote for the member s re-election. Lobbying is the ultimate manifestation of a citizen's right to speak freely and to petition the government for change. The First Amendment to the United States Constitution guarantees these freedoms and affords every American the opportunity to contribute input on the policies created by the federal government. How to be a More Persuasive Advocate Being a persuasive ambulance advocate and achieving success with your issue involves relatively simple tasks. Successful advocates do four things consistently to make contact with their member of Congress and to lobby ambulance issues: Personal Visits are the most effective way to make your case and should be conducted with regularity especially if Congress is taking action on your issue. Letters and emails should communicate the issue and ask for the member s support. Individually written letters from a state association, the leadership of ambulance providers, and individual constituents remain an important lobbying tool. Members of Congress often indicate they introduce or support legislation because they receive constituent mail. Telephone Calls placed to the member s staff continue the rapport established by personal meetings and can help you stay on top of any developments taking place. Social Media Engagement informs the member of Congress, their staff, and the public-at-large about your issue and its importance to the community around them. 8 7/1/2015

Ambulance Advocate Ambulance advocates are ambulance executives, managers, employees and organizations familiar with ambulance issues and who are able to take immediate action to influence lawmakers. Ambulance advocates make direct contact with the member of Congress through personal meetings, phone calls, emails, letters and social media posts. An Investment in Political Action Developing a relationship with a member of Congress and their staff requires a minimal investment of time. When there is action on an issue that affects the bottom line of your company, Congress expects to hear from you you should, therefore, expect to make regular contact with your member of Congress. At a minimum, plan to make approximately one contact (telephone, email, or letter) with your member of Congress, or staff, per month on issues throughout the term of a legislative cycle (approximately 8 months). In addition, you should plan to meet with your member at least once in the district and at least once in Washington each year. Estimated Investment of Time in Legislative Advocacy 1 call or email/letter (15 minutes) per month (over 8 months) + two meetings (1 hour) per year (over 8 months) 3 to 6 hours of legislative advocacy per year There are normally two sides to every issue and there are usually individuals or other forces (such as budget concerns) working to defeat your efforts. Therefore, devoting 3 to 6 hours of time every eight months is an important minimum investment that will protect your interests and influence the passage of legislation that benefits your operation. 9 7/1/2015

Personal Visits The following guidelines will assure a productive face-to-face meeting with your member of Congress: Plan your visit carefully. Be clear about the purpose of the meeting; determine in advance which staff member handles your issue. Identify which colleagues need to attend the meeting and clarify their role. Assign one person as the lead to open and close the meeting. Make an appointment. When setting up a meeting with a member, contact the lawmaker s Secretary or Scheduler. Explain your purpose and the organization you represent. It is easier for congressional staff to arrange a meeting if they know what you wish to discuss and your relationship with the member. Be prompt and patient. When it is time to meet with a member of Congress or staff, be punctual and be patient. Arrive 10 to 15 minutes early. It is common for a member to be late, or to have a meeting interrupted due to their crowded schedule. If interruptions do occur, be flexible. When the opportunity presents itself, continue your meeting with the member's staff. Be prepared. Whenever possible, provide information and materials supporting your position. Members of Congress take positions on many different issues. In some instances, a member may lack important details about the pros and cons of a particular issue. It is helpful to provide information and examples that clearly demonstrate the impact or benefits associated with a particular issue or piece of legislation. Before you leave, get business cards from staff. Be political. Members of Congress want to represent the best interests of their district or state. Whenever possible, demonstrate the connection between what you are requesting and the interests of the member's constituency. Be responsive. Be prepared to answer questions or provide additional information, in the event the member expresses interest and asks questions. Follow up the meetings with a thank you letter that outlines the different points covered during the meeting and send along any additional information requested. Focus on your priority issue. Stay on point and discuss your ambulance specific issue. Don t stray to other topics which may be highly partisan in nature. Be concise. Most meetings only last 15 minutes. Therefore, it is important to manage this short period effectively with no more than five minutes for introductions, five minutes to describe local impact and statistics and five minutes to make a clear request for action. 10 7/1/2015

Telephone Calls Telephone calls, versus letters, can give you direct access to the lawmaker and his or her staff which may result in a more immediate response to your issue. In addition, calls can be particularly effective when a crucial vote is suddenly approaching. You can reach any member of Congress through the Capitol switchboard at (202) 225-3121 (see Chapter 7 Resources for Effective Advocacy). You should not expect to speak directly to a member of Congress when you call, although this sometimes occurs. More often, you will speak with a Staff Assistant or Legislative Assistant. The following guidelines will assure an effective telephone call: Become familiar with the issue before making the phone call. Know the basic details of your issue such as the bill's number and name. By communicating these details, the lawmaker will have a better understanding of your request. Locate appropriate office. Lawmakers can be reached at either their Washington DC office or at their state or district offices. Members of Congress spend much of their time in their home states and are often more accessible at the district office than their Washington office. A member's Washington office can give you the phone number of their state/district offices (often there is more than one local office). Be sure to identify yourself. Provide your name, organization, phone number, mailing address and e-mail address. Be informed, direct, and polite. Lawmakers or staff may sometimes disagree with you at first, but may change their opinions later. Express appreciation. Remember to thank the lawmaker or staff for talking with you and acting on your suggestions. A friendly thank you will encourage the lawmaker and staff to agree with your stance and give you an opportunity to call again on future issues. Follow your call with a thank you letter. Briefly restate your issue and the specific action your request of your member. If they promised action during your phone conversation gently remind them by thanking them for their commitment. Emails and Letters Individually written letters from a state association, the leadership of ambulance providers, and individual constituents remain an important lobbying tool. Members of Congress often indicate they introduce or support legislation because they receive constituent mail. 11 7/1/2015

However, as congressional mail security has tightened and technology has advanced, email has become the most efficient way to get your message to your member of Congress and their appropriate staffer. Emails can be sent through your member of Congress s website, or directly to the staff member who handles ambulance related issues. It is also important to know that your emails and letters will likely be read and responded to by your congressman s staff. Because of the high amount of emails and letters received in congressional offices, most emails/letters are the responsibility of Staff Assistants, Legislative Correspondents and Legislative Assistants. This does not mean that your emails and letters will not be handled properly. Often times, congressional office staff have the ability to influence a congressman s decision based on email and letter correspondence with constituents. The following guidelines will assure an effective email or letter: Keep the email/letter brief. A one page, typed letter/email is more effective than longer ones. Say thank you first. Begin by thanking the lawmaker for previous support of ambulance industry issues. This praise will encourage the lawmaker to continue to take favorable positions. State your point early. A sharply focused letter discussing a single issue will generate better results. Use your own words. The lawmaker wants to read your thoughts and learn about your circumstances. State the bill by its number (when available) or name. A specific reference will help the lawmaker and staff identify your interest and investigate the bill. Relate the legislation to personal experience. Give the lawmaker specific examples of the way the bill will help people in your community and your operation. Ask specific questions. For example, ask the member to support your position. If you ask direct questions, you will have a better chance of receiving direct answers. Use official letterhead. When sending a letter on behalf of a state association or individual Ambulance provider, be sure to use an official letterhead. Doing so will help the member of Congress or staffer pay closer attention and associate your letter with past contact from your group. Email letter and send original by mail. It is appropriate to email letters on official letterhead as attachments in addition to sending the original by regular mail. Handwritten thank you and e-mail follow-up. Consistently follow-up with your members of Congress by sending thank you letters. A handwritten thank 12 7/1/2015

Social Media you note is an effective method. It is also appropriate to maintain contact with staff members via email. Members of Congress rely on social media to help them engage with voters and obtain an understanding on the issues that matter most to the constituency. With nearly every member of Congress having established an online presence, social media platforms like Facebook, Twitter and LinkedIn provide an opportunity for the public to engage their member of Congress in a real-time two-way conversation. Engaging your member of Congress through social media is incredibly beneficial for two reasons. First, it allows you to bring important issues to the attention of your member of Congress in efficient and diverse ways. Posting original content, pictures, videos, or links to traditional news stories and websites lets you tell your story in limitless ways. Second, your message will be available to the public-at-large helping you to gather grassroots support from those who may never have advocated for your issues otherwise. The following guidelines will help you effectively engage your member of Congress through social media: Keep your messages concise and on point. Social media platforms are not built for posting lengthy messages about your issue, and some even limit the amount of characters you can use. Be polite, but state your point early and stick to the facts of a single topic. Ask specific questions. For example, ask the member to support your position. If you ask direct questions, you will have a better chance of receiving direct answers. Say thank you. As often as possible post a thank you for you previous support of ambulance industry issues. This praise will encourage the lawmaker to continue to take favorable positions. Use Links. Wherever possible share a hyperlink where viewers can learn more. Share links to the AAA, state association, and individual organization websites. Share links to news articles, video clips, and any other media that effectively conveys the importance of ambulance issues. Just be sure that all links are made to highly credible sources. Use hashtags. Using hashtags on important key words like #ambulance, #EMS, #EMT, #paramedic, and #medicare, etc. will help organize all similar posts across the social media platform. This in turn allows the member of Congress, their staff, and the public-at-large to see all additional support for the issue. Additionally, these hashtags will help highlight the key words and phrases that your lawmaker and their staff should be associating with our industry. 13 7/1/2015

Be sure to identify yourself. If you are not posting via your organizations account, ask for permission to share the name of your organization and provide appropriate contact information should the member of Congress or their staff wish to contact you. Developing the Message First, be prepared to tell your unique story: Profile your service. Develop a one-page overview of your operation, including the types of services offered, area served, number of employees, years of service, local innovations, and partnerships with local public safety, public health and health care organizations. Emphasize contributions to community. Explain how your service benefits local constituents. Also provide an overview of the contributions you make to charitable organizations. Research local statistics. Become familiar with basic statistics about your community, including population, uninsured, economic status, etc. Describe the impact of federal policies. Carefully articulate the impact of federal policies on your service and the member s constituents. For example, accurately describe how federal reimbursement is below the cost of providing services. Second, be prepared to explain the national solution: Review national solution and talking points. Obtain information about the issue from the American Ambulance Association, including position papers, talking points, and sample letters. Relate the national solution to local community. Explain the benefit of the national solution to your operation and your community. Describe how the solution serves the public interest, is practical to implement and has widespread support among constituent groups. Determine position of your member of Congress. Research the position of your member of Congress on your issue or similar issues. Determine the member s voting record, public comments and previous advocacy on similar issues. Communicating with Your Member: The Do s and Don ts Regardless of the manner by which you communicate with your lawmaker whether it is by face-to-face meeting, letter, phone call, or via social media do: 14 7/1/2015

Know something about the lawmaker you are lobbying. At least, know his/her background, party affiliation, hometown, and if possible, whether he/she is on a congressional committee with jurisdiction over your issues. Have something to ask for. Before communicating with a lawmaker, be prepared with a specific request, such as co-sponsor a bill or send a letter of support those that don't ask, won't get. Remember that all politics is local. Define the problem in terms of the cost to your community give a specific local example that illustrates your point. Be concise. Lawmakers and their staff are extremely busy and are interested in the "bottom line." Focus on your legislative priorities. Avoid highly partisan issues during your contact and focus on the issues that affect your ambulance service. Know the political dynamics. Who is for and against your issue, who has influence over the politician, what is the lawmaker's political philosophy, etc.? Be confident. Be positive and assertive in making your case, but do not dismiss opposing arguments different views can help guide your future efforts. Stress why the issue is so important. It is essential to explain how the solution helps ambulance service providers and why the lawmaker should support or oppose the issue. Provide the most up-to-date and accurate information. You are the expert about your business and community so use accurate data to support your arguments. Ask for a commitment. However, don't expect a commitment. No elected official can be supportive 100 percent of the time. Do not expect to hit a "home run" every time you meet with a member. Organize group meetings. Rehearse before the meeting and task someone to be the leader or facilitator of the meeting. Take notes of your conversation. To use in follow-up with the member and to assure you provide information requested. Follow-up your contact. Send a letter or make a phone call that says thank you and briefly re-states your issues and asks for a position. Offer something new. On repeat visits, offer new information. As you prepare your communication, don t: Threaten, cajole or berate a member of Congress, their staff, or a fellow constituent. Whether in person, through a letter/email, or via a social media, do 15 7/1/2015

not engage in threatening or impolite and argumentative dialog. This is one sure way to lose a lawmaker's support. Be impatient. Understand that you are one of many constituents vying for a lawmaker's time and attention and that there are many sides to every issue. Respect that a decision may take time. Ignore or forget a request for further information. Being responsive to such requests not only observes a basic courtesy, but it gives you another opportunity to keep your name and issue under consideration. NEVER discuss political contributions while in a meeting with a member of Congress. At best, discussing political contributions is bad form and at worst, it is illegal and can be viewed as bribery. NEVER give a member of Congress or their staff a political contribution while in a House or Senate building. They are precluded from accepting political contributions while at work. Developing a Relationship with Your Member of Congress Members of Congress are constantly looking for volunteers to help them get re-elected or support local projects and charities they support. Below are ways to get face time with a member in order to develop a relationship that can be mutually beneficial and result in wins in Congress: Vote! Many people overlook this powerful tool that holds members accountable for their actions. Volunteer for your member of Congress re-election campaign. Volunteer with the local political party organization of your choice this will give you numerous networking and advocacy opportunities. Volunteer at the local charity that is a favorite of the member. Volunteer to write white papers on matters affecting your industry to help the lawmaker develop stances on some of the key issues facing the voters in your community. Invite your member (or their staff) on an operations tour and ride-along members and their staff enjoy getting firsthand experience and they often make site visits to a multitude of places. (See Chapter 5 - How to Host a Congressional Ride-Along) Invite your member and their staff to participate in local special events such as an Employee Recognition luncheon. Participate in AAA s annual Stars of Life gala and Congressional visits in Washington, D.C. 16 7/1/2015

Volunteer to host a fundraiser for your member (See Chapter 6 How to Host a Fundraiser). With few exceptions, the stimulus to which members of Congress most readily respond is constituent pressure pressure applied from grassroots actions and contacts. A disorganized, fractured and uninformed constituency will wield little influence and will be unable to achieve any legislative success. Your involvement as a grassroots lobbyist ensures that your view, those of your colleagues and those of your industry are effectively channeled toward influencing congressional decision makers to support your issues. When members of Congress know that members of the AAA are well organized, informed about the issues and willing to communicate ideas, they will pay attention to our concerns. Importance of Staff Contacts As you develop a relationship with your lawmaker, you will also realize the value of maintaining effective communication with his/her staff, including: Chief of Staff Legislative Director Legislative Assistant (such as health staff) Appointments Secretary or Scheduler Case Worker or Constituent Relations Representative (state or district office Campaign Staff Staffers will take action on your requests on behalf of the member, provide you with updates on progress of legislation, provide advice on how to generate support for your issue and provide feedback on what additional information is needed to make your case. 17 7/1/2015

CHAPTER 3 Community Outreach: How to Urge Others to Champion Your Issue Your member of Congress wants to know how many constituents will benefit and what other groups and individuals support your issue. Capitol Hill is crowded with a plethora of advocates and lobbyists all making their case to Congress to support one issue or another. Competition is stiff to distinguish any issue in the mind of a lawmaker as a worthy one and almost no health care provider can expect to win in this environment without the help of others. These challenges are precisely the reason well organized and sophisticated advocates have reached out to third-party organizations to help build a groundswell of support for an issue. These third-party groups have the ability to access an even greater number of people who can make noise about your issue and in the lively halls of Capitol Hill, an active and engaged third-party group can give your issue the edge it needs to succeed. Third-Party Advocate Third-party advocates are individuals, organizations and the public-at-large that are constituents of the members of Congress who are urged to take action to influence their lawmakers. Third party advocates support issues affecting community by contacting members of Congress through phone calls, letters, emails, social media, and faxes. Community Leaders Are Influential Advocates Asking other third-party organizations to get involved with the ambulance industry s efforts is an excellent way to create a groundswell of support for legislation that will benefit all ambulance providers and the communities in which they operate. Listed below are examples of the groups and individuals that should be included in local and state community outreach efforts: Patient Advocate Groups Former Patients Senior Citizen Groups Business Coalitions Civic Organizations 18 7/1/2015

City and County Officials Local EMS Regulators Public Safety Officials (police and fire) Public Health Officials Health Care Facilities and Clinics Medical Community and Emergency Physicians Organizations for Health Care Professionals Disaster Relief Groups Charitable Organizations Other Community Leaders State Ambulance Associations State Health and EMS Officials How to Engage Community Leaders in Advocacy Campaigns Listed below are a few suggestions for engaging community groups in advocacy campaigns: How will the issue help the community? Before you can expect third-party advocates to champion your cause, you must effectively and briefly explain how your solution will benefit the community. Assure Simplicity When community leaders express a willingness to support your issue, assure your request requires very simple action. Offer to provide all the necessary information and assure the instructions for action are very clear and concise. Letters/Emails. The most effective demonstration of community support is to ask community leaders, and, in some cases, the public-at-large to send a letter expressing support for your legislation or issue. The AAA has made this process very easy by providing a tool to help you locate your members of congress. Visit the following page on the AAA s web site to locate and find contact information for your representatives: http://cqrcengage.com/the-aaa/home Media Quotes. Community leaders, especially public officials representing local government, and including public health or health care officials, may be willing to make public statements about the need for Congress to support your legislation or issue. This may include offering interviews and quotes to local reporters working on a relevant story. 19 7/1/2015

Public Testimony. If you have effectively engaged in community activities over the long term, a few close allies affected by the issue may be willing to provide public testimony in support of your legislation or issue. Ongoing Community Service Generates Credibility Before you can expect community leaders to support your issues and assist you in championing your cause, individually and as an organization, you must have credibility. One of the most effective methods to obtain credibility is an ongoing commitment to community service. Building relationships over time will generate good will and offers a positive way to interface with community leaders. Public education programs, focused on offering helpful health and safety information, are also effective. Listed below are just a few examples of community service and public education activities: Disaster drills Public service announcements on winter weather tips, drowning prevention campaigns, etc. Citizen CPR and first aid programs Tips for safe driving near emergency vehicles and accident scenes Child safety seat checkpoints Bike-safety courses Blood pressure screenings at health fairs Volunteer work in civic organizations Contributions to charitable organizations Donation of ambulance services to indigent patients Sponsorship of community events Becoming familiar with your community s needs, opportunities and trends will help you identify the right combination of community service projects and public education campaigns. The goals of your community service activities should include targeting community projects to the most critical community needs; partnering with key community leaders; and providing a consistent organizational message. What s In It for You? Organizations that are a positive force for community change and a strong resource for the community, by definition interface with community leaders. In addition to generating a network of individuals and organizations that could provide assistance in a crisis or support 20 7/1/2015

federal legislation, effective community relations programs have many local benefits including the following: Local field and management personnel are more politically aware and involved in community activities Local and state officials understand the issues that are beyond local control and support federal advocacy efforts Relationships with local community leaders build opportunities to ask for support as third party advocates The local public is better informed about quality and efficient ambulance services Local media is educated about the issues affecting ambulance services in the community The bottom-line is that effective community service contributes to franchise protection and secures your organization s position in the community. 21 7/1/2015

CHAPTER 4 Media Relations: Why You Should be Courting the Press The most effective way to achieve greater success with legislative issues is to combine lobbying with community outreach and effective local media relations. Integrating these three strategies helps to reinforce your key messages and attract others to your effort. Lobbying is designed to reach the small audience of people needed to win your issues lawmakers. Media helps reach the other critical audiences (the general public, opinion leaders, and third-party organizations) who in many cases have great ability to influence key lawmakers. Local Media The local media includes newspapers, television news, radio news, social media and business journals that report current news events and information about issues that affect the local community. The local media highlights community issues through news articles, news broadcasts and editorials, with potential to generate public support for solutions. It s Easy to Become a Media Expert You do not need special expertise to secure print and broadcast media coverage. The process of getting the media to cover your issue is fairly simple but it does take preparation, patience and persistence you are competing for space or airtime with thousands of other people who have the same objective. What s In It for You? In today s information age, almost no one can hope to have an impact on Congress without the aid of the media. Effective media relations: Creates visibility for your operation. Creates a positive image for your operation and the ambulance industry as a whole. Lends credibility to your issue and the issues affecting the ambulance industry. Increases the urgency and or scope of your message. Creates the perception that your issue is important to the community. Determines whether your issue is considered in Congress. 22

One advantage the ambulance industry has over others competing for the media s attention is that ambulances are easily recognizable and provide an invaluable service to the community. If engaged properly and persistently, the media can help your operation increase opportunities for state and federal funding, create recognition for your services and increase the level of respect for the ambulance industry as a whole. How to Get Your Story in the News Effectively cultivating the media is an ongoing process use the tips below to help you get started and stay committed to the task. Create a Media List Get started by regularly monitoring local media newspapers, TV, radio, social media accounts, and local business journals to get a feel for the coverage and reporters. Next, create a media list: Monitor local news media. Jot down names of reporters you see covering stories related to your business, mission or the community s activities as they relate to the services you provide. Research local reporters and editors. Call the local newspaper, television and radio station and local business journals. Ask for the name of the editor and reporters involved with health-related coverage and the beat reporter covering police, fire and ambulance calls. Collect contact information. Assemble a list of reporters including their name, mailing address, e-mail address, phone number, twitter account, Facebook page, and fax number. Distribute Press Releases & Pitch Your Story To increase visibility for ambulance issues, regularly distribute information about your issues to your local newspaper, radio, television stations and social media: Focus on three points. Before contacting reporters to pitch your story, review your press release and fact sheet and decide what three points about your story might interest the reporter jot them down. Get attention. Email, call, Tweet, post on Facebook. Any and all means of communication should be used to get the attention you need. If faxing your press release, use a magic marker to write the name of the reporter and/or editor in the header of the press release or fact sheet. Clearly state your objective. Once you have made contact with the reporter or editor, state clearly who you are and why you are calling. I m calling to let you know how [name of ambulance organization] is going to help the community prepare for terrorist attacks. Be persistent. Ask if they received your press release and fact sheet and if they have time to discuss the issue. If they don t have time to speak to you ask if you can schedule an appointment. If they did not receive the information tell them you will resend the information. Ask for permission to FOLLOW-UP to see if they have questions about the materials. 23

Handling voice mail. If you get the voice mail of a reporter, it s best to not leave a message with the hope they will call you back (they most likely won t). Instead, make another phone call at a later time. If you decide to leave a voice message, sell your story as succinctly as possible and speak slowly and clearly when leaving your name and number. Say thank you. Before hanging up thank them for their time. Be patient. Do not be surprised if the story you are pitching does not come out as you expected or does not appear at all. Journalists report the news as they see it, not necessarily as you tell it. Interviews with Reporters When talking to a reporter, remember: Everything is on the record. Never assume that you can safely provide information off the record. Take notes during the interview. This will help you follow-up with the reporter following the interview and the publishing of the story. Control the exchange. Inject your key points often into the conversation. For example, make statements such as, What I would like people to remember is or Something you should know is Disagree with a reporter politely. For example, a reporter might ask, Would you say that and then adds a quote. If you don t agree with what has been said, politely disagree and restate your position, fact, issue, etc. But don t lose your cool. Be calm, cool and composed. Reporters are free to report the story as they see it that can sometimes include an in depth description of your attitude and reaction to questions during your conversation. Do not offer personal opinions. When representing your organization to the media, consistently repeat your key messages. Be truthful and sincere. If you don t know the answer to a question, tell the reporter you ll find out and get back to them. Avoid saying no comment. When replying to a question, this statement leaves the impression that you may have something to hide or are feeling defensive about an issue. If appropriate, say instead, I m not sure, I ll get back to you on that question. How to Create a Press Release Writing an engaging press release is easy as long as you follow simple principles that will help make your issue newsworthy to a reporter. If your press release does not entice the reporter immediately, your story will not get any attention. Follow these simple guidelines: 24

The most effective press release is one page in length. Press releases contain four paragraphs: an introduction, background on the issue, a quote and conclusion. Assure the headline grabs the attention of the reader instantly. The topic must inform and be engaging to the reader. Use the inverted pyramid method. Start with giving the conclusion of your story, followed by the most important supporting information and end with the background information. Answer the five W s. The text of the press release should explain why your story is important: WHO, WHAT, WHY, WHERE, and WHEN. Answer, at a minimum, two of the W s in the very first paragraph often the WHO and WHAT portions of your story. Add quotes. The quote should be from a credible source or expert on the issue. Assure that the quote has a clear purpose. For example, a good quote expresses an opinion, contains subjective ideas or explains actions taken. Assure easy-to-read text. Assure the text of the press release relays the information concisely. Offer additional references. If applicable, provide references for the reporter to research additional facts about the story. For example, provide additional web sites, other sources and experts. How to Write an Op-ed Article Because healthcare topics are often debated in the printed press, these debates present many opportunities to comment via the op-ed (i.e., opinion and editorial) pages of your local newspaper, including: Letters to the Editor. Generally written in response to a specific news story, to correct biased or inaccurate portrayals of a story, or to praise the activities of the individual or entity discussed. When writing a letter to the editor, make sure that you explain your relation to the subject matter and why what you are saying is important to the debate. Op-ed Opinion Articles. These articles are written to express a specific point of view on a subject using supporting research and facts. Many individuals and organizations use this method to express solutions to problems discussed in current events or to present new ways to look at an issue that is being reported by the media. Securing an op-ed article requires the same effort as generating a story based on a press release. Both require time and patience to get them placed in the local paper. Look for instructions on how to submit your article in the op-ed section of your local newspaper. Listed below are tips for writing the op-ed article: Be newsworthy. Submit articles related only to topics recently discussed in the media. Be brief. Keep the length of your article to between 500-800 words, double-spaced. Localize the issue. Provide information and or statistics that will provoke discussion and provide a solution on the issue. 25

Timing is everything. Connect your op-ed to the release of a new survey, new community event, etc. Secure an expert. If you are not the expert, select one that is and ask them to sign the op-ed on your behalf. Often, the more significant the person is in the community, the more likely it is that your op-ed will be published. Approaching an expert is also a great way to get third parties involved with your issue. Follow-up. Once you have submitted your article, follow up with a phone call to the op-ed editor a few days later. Ask the editor about the status of the article and if it has been selected for publication. Constant communication with your newspaper will establish you as a local expert and will often result in a greater chance that your article will be published. Topics worthy of expert commentary include: Describing the status of local terrorism preparedness efforts. Proposing solutions for the shrinking health care resources in the community. Advocating community support of federal funding programs assisting local ambulance providers. Highlighting the effectiveness of public health and public safety community partnerships. Reporting on the participation of local ambulance providers in national events such as the Stars of Life awards. 26